Anti-Inflammatory Diet and Dementia in Older Adults With Cardiometabolic Diseases

Key Points Question Can an anti-inflammatory diet support brain and cognitive health among people with cardiometabolic diseases (CMDs)? Findings In this cohort study including 84 342 older adults from the UK Biobank, participants with CMDs and an anti-inflammatory diet compared with a proinflammatory diet had a 31% lower risk of dementia. In addition, significantly larger gray matter volume and significantly lower burden of white matter hyperintensities were observed on brain magnetic resonance imaging in those with the anti-inflammatory diet. Meaning The findings of this study suggest that lower dietary inflammatory potential may support brain and cognitive health among people with CMDs.


eFigure 2 .
Trajectories of DII scores over multiple assessments in the anti-inflammatory, neutral, and pro-inflammatory diet groups.Spaghetti plots include data from participants in the anti-inflammatory (DIIavg ≤-1.5 pts), neutral (DIIavg >-1.5 to <0.5 pts), and pro-inflammatory (DIIavg ≥0.5 pts) diet groups for whom DII information was available baseline and at least one additional assessment.Each thin blue line represents the trajectory of one participant's DII scores over multiple assessments.The thick black lines represent the trend in DII score over time.

eFigure 1 .
Study population flowchart.eTable1. Neurological disorders used as exclusion criteria for the neuroimaging subsample.UK Biobank Field Codes used to ascertain baseline CMD status.Inflammatory effect scores and globally daily mean intake for 45 dietary parameters included in the Dietary Inflammatory Index (DII).

Table modified
Baseline characteristics of the neuroimaging subsample (n=8,917).Comparison of participants included vs. not included in the neuroimaging subsample.Summary of main results using non-imputed data for covariates.Hazard ratios (HR) from Cox regression models for the associations of CMD status and dietary inflammatory potential with dementia risk, after excluding 109 study participants who developed dementia within the first 5 years of follow-up (n=84,233).Subdistribution hazard ratios (SHR) from Fine & Gray regression models for the associations of CMD status and dietary inflammatory potential with dementia risk, accounting for the competing risk of death.Association between dietary inflammatory potential and CRP: results from linear regression models.Basic-adjusted models included age at baseline, sex, education, and energy intake.Multi-adjusted models additionally included race/ethnicity, socioeconomic status, body mass index, smoking status, physical activity, hypertension, and APOE ε4 carrier status.eTable11.DII scores over multiple assessments in the anti-inflammatory, neutral, and proinflammatory diet groups.
Summary of main results including only participants who completed two or more dietary assessments (n=51,182).
All models were adjusted for age at baseline, sex, education, energy intake, race/ethnicity, socioeconomic status, body mass index, smoking status, physical activity, hypertension, and APOE ε4 carrier status.Brain MRI analyses were additionally adjusted for head position, scanner table position, and assessment center.eTable 13.Summary of main results using DII score calculated based on only baseline dietary assessment (n=29,175).